Migraine is more than a biological category
You know the old philosophical riddle: If a tree falls in a forest and nobody is there to hear it, will it make a sound?
Well, there’s a similar idea in sociology (although maybe a bit less catchy): a “social problem” does not exist until it is named, identified, and publicly recognized.
Migraine is a good case-in-point, as I learned at last week’s Headache on the Hill event, sponsored by the Alliance for Headache Disorders Advocacy.
Twenty per cent of women and 6 per cent men will experience a debilitating migraine this year. Four per cent of American adults experience a headache disorder more than fifteen days per month. Migraine costs an estimated our government an estimated $32 billion dollars per year in lost productivity and healthcare costs. According to the World Health Organization, migraine is the 19th most significant cause of disability worldwide and the 12th most significant cause of disability for women.
That sounds like a social problem to me.
And yet public response has been rather weak. In any given year, the National Institutes of Health (NIH) spends at most $15 million dollars on migraine-related research. Other headache disorders, like chronic daily headache and cluster headache, receive almost no public funding at all. Compare this to federal funding research on epilepsy ($105 million), asthma ($294 million), or ovarian cancer ($103 million). Migraine is just as important as those diseases — and, by some measures, presents even more of a burden to our society. But our federal government hasn’t yet recognized it as a problem that deserves research dollars on par with other diseases.
The next obvious question is why? I think it’s important to recognize that conditions like migraine are more than biological categories — they are also political entities. Washington DC is filled with disease interest groups that lobby the federal government for more money. There are huge advocacy efforts behind the research dollars spent on epilepsy, asthma and ovarian cancer.
The Alliance for Headache Disorders Advocacy is in its fourth year of doing just this — asking Congress to fund headache additional headache research. These kinds of claimsmaking activities are crucial in the process of transforming conditions like migraine into social problems -- that is, problems that our whole community rallies around, supports and funds
 All figures come from FY2007. Robert E. Shapiro and Peter J. Goadsby, "The Long Drought: The Dearth of Public Funding for Headache Research," Cephalalgia 27 (2007).
How much has your migraine disease changed or evolved over time?